Enrolling in the health service (SSN)

Cost note for the economically inactive. Workers and their families enrol free. If you have no work in Italy and enrol voluntarily, since 2024 a national rule sets the contribution at a minimum of €2,000 per year (students pay a flat €700) — and it covers the calendar year, not pro-rated: you pay the full amount whenever you enrol and it expires on 31 December. See the cost section below.

Once you are a registered resident (Step 2), you can enrol in the Servizio Sanitario Nazionale (SSN) — Italy’s national health service — at your local ASL (Azienda Sanitaria Locale). Enrolment gives you a tessera sanitaria and lets you choose a medico di base (family doctor) free at the point of care.

Who can enrol, and how

Workers (employed or self-employed) and their dependants generally enrol on the basis of their work and residency.
Economically inactive EU residents (no work in Italy) either hold private health insurance or enrol voluntarily in the SSN for an annual contribution — since 2024 a minimum of €2,000/year (see the cost section below).

The process

Go to the ASL for the area where you are registered as resident.
Present your ID, codice fiscale, attestazione di iscrizione anagrafica, and proof of your status.
Choose a medico di base from the available list.
Receive (or be sent) your tessera sanitaria.

What voluntary enrolment costs (economically inactive)

If you are not working in Italy and don’t otherwise qualify for free enrolment, you can still enrol voluntarily — but since the 2024 Budget Law this is deliberately costly and, in the key respects, uniform nationwide:

Minimum €2,000 per year for the economically-inactive / elective-residence category. It is income-scaled (7.5% up to €20,658.28, then 4% above) but never below €2,000. Enrolled students pay a flat €700.
It covers the calendar year and is not pro-rated. You pay the full amount whenever you enrol, and it expires on 31 December — you renew and pay again each January. There is no partial-year or back-dated option, so enrolling in, say, July still costs the full year.
Paid to the tax authorities on an F24 form, then registered at your ASL.

At €2,000+/year this often costs more than private sickness insurance, so many economically-inactive EU residents weigh the two. The health authority is regional/provincial, so confirm your exact figure locally (see your region’s page).

You’re settled

With the codice fiscale, registered residency, and SSN enrolment in place, you have completed the core legal steps of establishing yourself in Italy as an EU citizen.

What would it cost you? (voluntary enrolment)

National formula since 2024: 7.5% of the previous year's income (worldwide) up to €20,658.28, plus 4% on the excess up to €51,645.69 — never below the €2,000 floor. Students: flat €700; au pairs: €1,200.

Examples
Annual income	Contribution
€25,000.00	€2,000.00 (floor)
€40,000.00	€2,323.04
€51,645.69	€2,788.87 (maximum)

Student (no other income): €700 · Au pair: €1,200

Covers the calendar year and expires on 31 December, whatever the enrolment date. Paid via an F24 form. Informational estimate — confirm the exact figure with your ASL.

In Puglia

In Puglia, the health service is delivered through the ASL (Azienda Sanitaria Locale) for the province where you are registered as resident (in Bari, this is the ASL Bari).

Where to enrol: the ASL covering your registered address; use the Regione Puglia health pages to find it and its counters (sportelli).
Choosing a doctor: select a medico di base from those available in your ASL district.
Economically inactive EU citizens: enrolment here is voluntary — and since 2024 it costs a national minimum of €2,000 per year (students €700), charged for the whole calendar year regardless of when you enrol and expiring on 31 December. That floor is the same in every region (see the cost section above); confirm the enrolment steps with your local health authority.

Frequently asked questions

Where do I enrol?

At your local ASL (Azienda Sanitaria Locale), the health authority for the area where you are registered as resident.

What is the tessera sanitaria?

It is the health card showing your codice fiscale, issued once you are enrolled in the SSN. It is used to access doctors, prescriptions, and treatment.

Is enrolment automatic?

For workers and their families it is free and follows from your residency and status. If you are economically inactive and enrol voluntarily, since 2024 you pay a national contribution of at least €2,000/year (students €700) for the calendar year, expiring 31 December — confirm your exact figure with your local ASL.

I'm an EU pensioner — do I have to pay the voluntary contribution?

No. Ask the health institution of the state that pays your pension for form S1 and register it at your ASL — it entitles you to full SSN coverage without the voluntary contribution, on the same terms as Italian residents.